The present disclosure relates to a dynamic stabilizing system for spinal columns capable of stabilizing the spinal column without spinal fusion.
A multitude of rod/screw connections is available for metallic rods and used mainly in fusion operations (spinal fusion). There are only a few elastic systems that only support and stabilize, but do not fuse, the spinal segments and, thus, there are only a few devices for attaching the elastic connection elements to the pedicle screws.
As a matter of principle, rod/screw connections that are suitable for metallic rods are not necessarily also suitable for elastic connection elements since elastic rods made of plastic material, for example, possess different properties than rods made of metal that are stiffer by comparison. Accordingly, elastic rods made of plastic material cannot be simply clamped in a lasting fashion by means of frictional or force-fit connection since they usually are capable of reducing the clamping force by flowing. Consequently, there is a need for connection concepts comprising, aside from a possible frictional-type clamping, a contribution by form-fit which they attain for example by local elastic or plastic deformation.
WO 95/01132 (Schläpfer et al.) can achieve increased pressure in the contact zone by means of a sphere in the clamping screw. DE 4234118 A1 (Harms et al.) can achieve increased pressure in the contact zone by means of the edge of the hollow fixation screw. U.S. Pat. No. 5,005,562 (Cotrel) can achieve increased pressure in the contact zone by means of a circular toothed profile on the clamping screw. WO 03/015648 A1 (McKinley) can achieve increased pressure in the contact zone by means of teeth under the hat-shaped clamping screw. Even though the special features of the above-noted references can achieve increased pressure in the contact zone and therefore elastic or plastic, as it may be, flowing locally at the rod surface, such increased pressure would be insufficient in the case of an elastic rod made of plastic material.
U.S. Pat. No. 6,117,137 (Halm et al.) comprises grooves at the lower rod receptacle in the screw head but these only serve to provide additional support against longitudinal displacements. Moreover, the side opposite from these grooves does not possess a matching complementary structure.
EP 0 689 798 B1 (Sebastián Bueno et al.) comprises a receptacle that is non-congruent (“egg-shaped”) to a round rod which can increase the clamping force of a metal rod. Since this profile does not comprise a specifically matching shape on the opposite side, it is unsuitable for an elastic rod made of plastic material due to the risk of flowing and reduction of tension.
EP 1 364 622 B1 (Freudiger) and EP 1 527 742 A1 (Freudiger) comprise mutually geometrically matching form-fit anchorings and thus are suitable for connecting an elastic rod made of plastic material rod to a pedicle screw. However, the positioning of the grooved surfaces requires very precise insertion in order to prevent canting. Moreover, grooved surfaces do not allow for continuous positioning.
U.S. Pat. No. 6,478,797 B1 (Paul) and US 2003/0125742 A1 (Yuan et al.) both comprise filling pieces that allow for all-around clamping of the metal rod when inserted from above. However, neither of the two systems comprises surface structures in the area of clamping that would be suitable for an elastic rod made of plastic material by means of a sufficient form-fit contribution.
FR 2739548 (Huitema) comprises a grooved connection on part of the circumference of the metal rod. Since the bushing with the groove must be applied to the rod by pushing, the bushing is not suitable for an elastic rod made of plastic material due to the risk of jamming.